Case of non healing diabetic wound where Curzinc sped up the healing process

A 57 years old lady come to my clinic for non healing wound for over one month. She is a case of diabetes mellitus and was treated in the DH with injection insulin and oral Metformin. Her blood sugar is said to be well controlled.

On examination, she is obese with huge thighs. A wound size 2 cm is at the medial of left thigh, 3 cm below the inguinal ligament. The wound is very deep, half of the artery forceps can go in and there was greenish yellow pus discharge.

A wide extension of wound was done under LA. Desloughing was done. She was put on silicea, gun powder, myristica and fucidin and hyal dressing. The wound not only make no improvement but progressively extended laterally. Repeated wider excision have to make to cope up the speed of wound extension and rapid closure of wound opening.

After one month, I changed the medications to cefuroxime and noflux, the pus become lesser for a few days and wound become fulminating again. I asked the patient to go to the hospital as no progress was done by me. She refused and said she will rather die if I sent her to hospital.

I then did a random blood sugar on her, it was 4.6. Repeated RBS 2 days later was 4.5. So I suspected the GLUT 4 may not be functioning in such low sugar.
Earlier I had done a case of Diabetes mellitus with pseudoparaplegia on wheelchair. I gave her Ruta 1 m 4-4-4. On follow up 1.5 months later, she can stand up from wheelchair and do her daily activities. This was because in DM with the lack of insulin, glucose cannot enter the cells, but GLUT 4 can enable glucose to enter the cell by facilitated diffussion against glucose gradient, provided the blood glucose is not too low. Ruta can increased GLUT 4 to overcome the insulin deficiency to obtain glucose to enter the cells. In the lack of glucose for energy, the adipose cell, skeletal, cardiac cells will undergo artrophy and die.

So I put this patient on Ruta 1m 4-4-4 and staphysagria, calendula. In the meanwhile I decreasde her insulin by 2 units and advised her to take more fruits to increase her blood sugar and Vit C. I also did a real wide extension of wound to 3 cm beyond the necrotic wound edge. On daily dressing, I can see the wound finally make a slow recovery with less pus and less invasive extension of wound size.

Later I received the Curzinc for my BPH patient. This reminded me that zinc is very good for wound healing. Curcumin can facilitate the diffusion of zinc to the cells and is a powerful antioxidant, so I also add curzinc 20-0-20 for her. Only 3 days later, I can see the wound turned pink and become lively, granulating, cleaner and become shallow. The patient can also can feel the contraction of the wound.
This morning, I do a secondary suturing for her to speed up the healing and prevent gaping wound healing by extensive scarring.

Note :

• Ruta can be extensively used in diabetic patients with muscle wasting.
• In wounds with pus its hepar sul, calendula, gunpowder.
• Hepar is very useful when there is pus.
• Sillicea is when there is thin clear discharge
• For wound healing arnica,calendula is very useful so it doesnt scar